Logistics, Meetings, and Evacuations

Almost perfectly timed during my classroom-to-clinicals transition period from American University of the Caribbean School of Medicine (AUC), the 2017 ASCP Annual Meeting in Chicago was an excellent opportunity to get back to my lab roots. The Annual Meeting is always an excellent opportunity to expand lab-related knowledge, learn some new clinical skills, and easily network with colleagues. Professional societies like ours are highly dependent on the partnership and collaboration of our fellow scientists, sponsors, and clinicians. I have been fortunate enough to attend two of these meetings as an award recipient bookending my pre-clinical years in medical school. In 2015, I attended the ASCP Annual Meeting in Long Beach, California as a Regional Member of the Year. This year’s Annual Meeting was held in my hometown of Chicago, where I’m proud to say I attended as a 2017 ASCP Top 40 Under Forty honoree! But these meetings are more than just conferences with awards ceremonies—at every ASCP meeting I reconnected with old friends in workshops, shook hands with our great ASCP leadership, and collaborated with colleagues in roundtables or other sessions. There is a place for all of us in laboratory medicine. Our respective insights bring something valuable to the final outcomes of improved patient care. Nowhere is this more evident than the Annual Meeting.

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Image 1. ASCP Annual Meeting Chicago 2017, Top 40 Under Forty, and ASCP CEO Dr. Blair Holladay

Among the endless list of educational events and sessions, I especially enjoyed being a collaborator in round table discussions including “The Benefits of Data Integration in Clinical Decisions.” I truly enjoy these roundtables and wish I could have done more of them! Topics included effective feedback, utilization and evaluations, education, and global health initiatives—all of which I’m sure I’ve written about in one way or another this past year. Seeing some of the content in my online Lab Management University (LMU) modules applied in real-life situations was reaffirming. Attending sessions and meeting renowned experts from informatics to hematopathology was exciting. The keynote speakers were captivating. Dr. Birx’s discussion on PEPFAR and global health initiatives clearly piqued my interests, and Drs. Caliguiri and Pritchard’s lectures on analytics and resources spoke directly to my work in cancer research. And don’t forget: it’s all worth continuing education credit—can’t beat that.

I would just like to simply thank ASCP again for all the work that goes into these meetings. I know from experience that planning large events involves quite a bit of logistics. And in managing these events ASCP truly provides an excellent environment to collaborate and learn. What brought this appreciation for logistics to the forefront was a disaster that had unfolded in the week prior to the meeting. On the island of Sint Maarten, the location of my medical school and my home for two years, was absolutely decimated by hurricane Irma. The school managed to withstand for the most part intact and acted as a shelter for students, faculty, and family. While being sheltered from that storm, endless homes, apartments, and business were destroyed. Taking nothing but a suitcase or two to campus ended up the only possessions many people in the AUC community had left. The school and its administration did a spectacular job creating a stable, safe, and even comfortable environment for students and their families while evacuation efforts were organized. While AUC managed to get students off the island via military assistance and/or charter flights, evacuees were taken to the Chicago suburbs. Right after the ASCP Annual Meeting I began having conversations with contacts in the Chicago Department of Public Health and Emergency Preparedness to offer assistance. I provided contact data, relayed satellite telephone numbers to the right contact points, and provided relevant information regarding demographics, health, and needs. Both my wife (a trained nursing leader) and myself were happy to be involved with connecting critical points in this process. All the students and their families were accounted for and taken care of in the Chicago suburbs, and were later moved to the new school location relatively unscathed. Logistics from a distance can be difficult, especially when it’s behind-the-scenes. A lot of lab decisions are made that way, and ultimately we do our best for our patients.

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Image 2. Resort and villas halfway between my apartment and AUC campus on Sint Maarten before the hurricane.

 

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Image 3. Resort and villas halfway between my apartment and AUC campus on Sint Maarten after the hurricane.

The take home message: be flexible, be humble, and be helpful. If we want to improve patient outcomes, we need to work with evidence-based approaches matched with intelligent compassion. As laboratorians, we apply our scientific approach to critical life-saving algorithms. This was no exception. Lessons discussed at the Annual Meeting between networking colleagues and official sessions are accurate. Tap into your resources, keep an active and dynamic network, know what you can do and what you cannot, and always try to help. That’s what makes a good laboratorian, a good clinician, a good friend, and hopefully a good physician.

Thanks for reading! If you’re interested in donating to disaster relief for anyone affected by this year’s violent hurricane season in Sint Maarten, visit www.rotarysxm.org.

 

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Constantine E. Kanakis MSc, MLS (ASCP)CM graduated from Loyola University Chicago with a BS in Molecular Biology and Bioethics and then Rush University with an MS in Medical Laboratory Science. He is currently a medical student at the American University of the Caribbean and actively involved with local public health.

ASCP Annual Meeting Call for Abstracts Now Open

The 2017 ASCP Annual Meeting is in Chicago, IL September 6-8. If you’d like to present your research at the meeting, the call for abstracts is now open. Summarize your work in 300 words or less and submit it through the online portal by March 20th, 2017.

Spread the word, and good luck!

 

Potential Antimicrobial Therapy Hiding in Plain Sight

Yesterday, Nature published a paper that might help in the fight against MRSA. In a nutshell, German researchers discovered that Staphylococcus lugdunensis–a common bacteria in commensal flora–produces a compound that reduces colonization with MRSA.

From the abstract:

“Notably, human nasal colonization by S. lugdunensis was associated with a significantly reduced S. aureus carriage rate, suggesting that lugdunin or lugdunin-producing commensal bacteria could be valuable for preventing staphylococcal infections.”

 

ASCP 2015 call for Proposals

ASCP 2015 ANNUAL MEETING – CALL FOR PROPOSALS
The 2015 Call for Proposals is now open! The ASCP 2015 Annual Meeting will be held in Long Beach, CA October 28-30. If you submitted a proposal for the 2013 or 2014 Annual Meeting, you can log in with your same username and password. You can edit and resubmit your previous proposals and add new ones. The deadline date is Monday, December 8th.

Please inform any co-presenters that you will be submitting a proposal as they will receive an email asking for demographic and disclosure information right after you submit the proposal.  Complete the proposal at ASCP 2015.

Reminiscing Tampa

ASCP 2014 at Tampa provided the perfect getaway for a New Yorker forced to wear fleece early October. The same attire seemed to be mocking me the moment I stepped out of the Tampa International Airport on Wednesday night. It was a pleasant surprise and I gleefully tucked it right into my suitcase.

At the hotel, I took a quick glance at the lecture schedule. Having already missed the first day, I was eager to extract the best out of the next two days. I was thrilled to see an array of topics specially aimed at residents. Also, many lectures focusing on novel or state-of-the-art techniques, including molecular methods, virtual microscopy, digital pathology, informatics, etc. It seemed to me like “The future beckons!!” Being a hard-core morphologist, it was a tough call for me, as I would have to forego a host of other good lectures. But I decided to focus on the resident review courses and ancillary techniques.

Keeping with my agenda, I set the ball rolling on day two by attending the lecture on “Automating Anatomic Pathology.” It was an eye opener for me, dealing with the scope and future of automation in anatomic pathology lab. “Anatomic Pathologist’s Role in Patient Safety” was the next. Dr. Silverman cited studies revealing that soft tissue lesions, with an error rate of 20-30%, led the list of organ specific error rates. He deliberated on the importance of second opinions in error reduction. He aptly concluded his lecture with the remark, “the pathologist is the Final Quality Assurance Officer or ‘the buck stops here.’” It was a huge wake up call for me.

I moved on to my first lecture on Molecular Pathology, “Welcome to the Beginning: Molecular Pathology for the General Pathologist and Molecular Pathologist.” It was just the right one for me and helped me firm up basic concepts. In the evening I attended “Molecular Diagnostic Methods in Oncology: an update on practical aspects.” Dr. Larissa Furtado and Dr. Yue Wang from University of Chicago were simply brilliant in elucidating the role of molecular techniques in oncologic practice. The prior morning session, helped me understand the deliberations in this talk much better.

I made it a point to attend most of the Resident Review courses. Though my Board Exams are two years away, I took it as a perfect platform to acquaint myself with the “hot” topics. I spent almost the entirety of day three attending the courses. A packed audience was testimony to these sessions’ popularity. Most of the speakers were brilliant. The case based presentations followed by an interactive voting format helped keep us all fully involved. However, the lab administration and last day hematology section could have been better.

In between, I found some time to listen to one of my all time favorites: Dr. Goldblum’s trademark lecture on soft tissue pathology. He quipped in his inimitable style “Don’t hunt for lipoblasts to diagnose a liposarcoma” and warned us of the vast plethora of “pseudolipoblasts” lurking around. Rather, he stressed the importance of analyzing the entire histology in the correct clinical context.

Let’s wander into the poster sessions! We had a total of twelve posters from our program itself, probably the largest representation from a single center. I had four posters and one of them was selected as a finalist in the Best Resident Poster section. It was an entirely new experience for me. However, I did some homework to prepare myself for the judging session. The judges on both the days were very pleasant and spent a significant amount of time discussing the work with me. It was disappointing not to get the award, though I knew the competition was tough.

The evening Mixology Lab was the perfect concluding session in the backdrop of the setting sun across the scenic Hillsborough river. There was delicious food and wine as Dr. Baloch announced the various poster award winners. It was special for me for another reason, as my very good friend Shree Sharma was one of the “top 5 under 40” award winners.

Mixology Lab attendees soaking up the sun.
Mixology Lab attendees soaking up the sun

It would be so improper if there were all work and no play. Friday evening provided the perfect opportunity to explore the city. I went out with friends to the Ybor City, taking the streetcars, which surprisingly provided 50% discount to conference attendees. Ybor City was such a happening place, full of fun. While strolling along the 7th avenue, we took pictures with people celebrating Gasparilla festival, dressed as pirates. A glass of sangria at the historic Columbia Restaurant provided the perfect toast to end the day.

My trip was not to end here as I had already registered for the TRIG Genomic Pathology Workshop for Saturday. This was my first exposure to such a session in molecular technology. We were divided into small groups. In a case based approach, the workshop deliberated on teaching principles related to the development of genomic assays and result interpretation. There were four cases pertaining to single gene testing, prognostic gene panel testing, how to design a cancer gene panel and whole genome sequencing, respectively. Both Richard Haspel and Andrew Beck were simply brilliant and they took special care to approach each group separately and clarify their doubts. It was a highly stimulating experience for me and I learned a whole new facet of pathology. The utilization of online genomic pathology tools for result interpretation appealed to me. It also gave me the opportunity to work with fellow residents from other programs in a very close and interactive manner. Though the warm sun outside beckoned, I believe this was the perfect finale for three full days of extensive learning activities.

A trip to Tampa would be incomplete without a visit to the Florida Aquarium. I took a relaxed tour of the aquarium after the workshop, visiting the lovely marine friends. When I boarded the flight back to New York on Sunday afternoon, I felt very content. It was also reassuring to see that ASCP indeed cares about resident education and needs. The meeting opened my eyes towards the new horizons in pathology and how many options lie before us for shaping our careers.

 

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-Rifat Mannan, MD is a second year Pathology resident at Mt Sinai St.-Luke’s Roosevelt Hospital Center, New York.

A Bayfront Convention – ASCP 2014 in Tampa, FL

From October 8-10th this year, ASCP members met at the Tampa Bay Convention Center. The convention center overlooks the picturesque calm waters where the Hillsborough River drains into Tampa Bay, waters which are alight at night with city lights and reflections from neon-lit bridges. Opposite the convention center stands the imposing figure of Tampa General Hospital, the metropolitan area hospital at which the University of South Florida residents undergo portions of their training.

Inside, the atmosphere was quiet and relaxing on the first day. Pathologists, cytotechnologists, laboratory professionals, residents, fellows, and others mulled about, some sipping coffee and catching up on news, others hurrying to get to one of the many available lectures or seminars.

Some lectures were star-studded, others from lesser-known speakers, but they were outstanding overall in subject and quality. Dr. Richard DeMay’s lecture on cytopathology was a real treat; he interjected humor and humility into his lecture, a remarkable feature for someone with an internationally renowned series of books under his belt. It was fascinating to watch him speak, with his keen blue eyes and wavy brown hair, with a single shock of white at the front. His demeanor was poised but colloquial, brilliant but accessible. I had the pleasure of shaking his hand after and thanking him for his contributions to the field, but others were more prescient; attendees lined up afterward to get their books signed and have photos taken.

Some of the more popular lectures had standing room only, although arriving 10-15 minutes prior to the start guaranteed a seat. Pathologists – old and young – stood up against walls or sat on the floor, fumbling with beverages and notepads, to hear about Head and Neck Surgical Pathology and Medical Liver Pathology. Yet other lectures had to be missed; I regret not being able to attend what I heard was a high quality lecture given by Steven Marionneaux, MS, MT(ASCP) on the topic of platelet counts and their impact on transfusion protocols.

The resident review courses, designed for pathology residents for the purpose of board review, were well done also. They were narrower in focus than many of the other lectures, but cut into the meat of their subjects. For the fourth-year residents who attended, no doubt the reviews served as a free complement to the Osler Review courses, which began on the Sunday in Tampa following the convention.

By Thursday, the posters and exhibits were up, and the exhibit hall (Science Connections Central) was bustling with activity. Presenters from all over the country (and some international) with varied backgrounds were there, with posters on everything from laboratory media for HPV testing to the utility of peripheral blood examinations of myelodysplastic syndromes.

The exhibits were the standard fare, with laboratory hardware vendors, molecular testing services, and booksellers all present. My favorite, after meandering for some time, was the Pathology Outlines booth with Dr. Nat Pernick. He was gracious enough to share his impetus for founding his company, which was to eliminate the need to carry books when he went from site to site doing PRN work in the Northeast, He was also gracious enough to give me an autograph. I had learned my lesson from the previous day.

After rounds of lectures, and a boisterous Lab Management University graduation ceremony, ASCP 2014 began to wind down. The Friday lectures grew more sparsely attended throughout the day, but many stayed for the ending awards ceremony.

On Friday evening, at the cusp of dusk, drinks and hors d’ouvres were served, and sharply dressed laboratory professionals watched as ASCP President Dr. Steven Kroft thanked everyone for coming, and the poster awards were handed out. The international award recipient gave an excellent improvisational speech, telling the assembly that he was honored to be studying in the United States, and that he looked forward to becoming “stronger together,” a nod to the ASCP’s newly minted motto. Yet my favorite award recipient was Dr. Kun Jiang of Moffitt Cancer Center, one of my attending physicians and in my considered opinion one of the most talented pathologists in the country. With his characteristic humility, he gave no speech and hurried off the stage too quickly to be photographed, but we were glad to see recognition of his hard work and talent. He was the recipient of much hand-shaking and back-slapping when he returned to his table.

Dusk came over the bay, but the convention was not yet over. Residents were invited to a classy meet-and-greet reception at Jackson’s Bistro, an upscale restaurant just a short walk away. Dr. Kroft appeared again to remind the residents that we are the future of pathology, and to inspire us to embrace the legacy we were being left with. Dr. Rebecca Johnson was there also, and it was interesting talking to her. I learned that the pathology board exams are not scaled with a Gaussian distribution, with the necessity of a certain number of exam failures, but are structured using a standards-based approach. This ensures that minimal criteria are met, and failure is not essential to the examination model. So, theoretically, everyone can pass on the first time. That knowledge was perhaps as inspirational as Dr. Kroft’s parting words.

The music popped on and residents mingled with residents, students, attendings, and a few others who showed up. It was a lively and convivial atmosphere with swimming lights, laughter, and good times. Smiling faces abounded as a room full of stressed and overworked people took at least one night out of the year to live a little. They also exchanged stories and news, cards and numbers. It was one of those moments of being caught up in l’esprit de temps, not as part of a country or a movement, but as part of a select group of people who have dedicated their lives to the accurate diagnosis of disease. We are a truly unique group in these modern times, caught between the legendary accomplishments of our forebears and a growing world of scientific modernity. I looked over the water for a moment, over the orange and white dots and the neon streaks, and I wondered, what will our future be?

 

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-Michael Markow, MD is a third-year resident at the University of South Florida, Tampa, FL